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Multivessel Coronary Artery Disease Presenting as Supraventricular Tachycardia in an Elderly Woman: A Case Report
Abdulrahman Al-Qaysi1, Zainab Al-Qaysi2, Bobby Diniotis3
1Department of Family Medicine, High Street Medical Centre, Dungarvan, IRL.
Insights
Supraventricular tachycardia (SVT) can cause troponin elevations, but these may signal severe coronary artery disease (CAD) rather than just demand ischemia. Rising high-sensitivity troponin (HS-Tn) after SVT warrants thorough evaluation for obstructive CAD, especially in at-risk patients.
Area of Science:
- Cardiology
- Clinical Medicine
- Diagnostic Imaging
Background:
- Troponin elevations during supraventricular tachycardia (SVT) are typically attributed to demand ischemia.
- Distinguishing SVT-induced myocardial injury from acute coronary syndrome (ACS) can be clinically challenging.
- Obstructive coronary artery disease (CAD) is often overlooked as a cause of troponin elevation during SVT.
Abstract:
Troponin elevations occurring during supraventricular tachycardia (SVT) are often interpreted as "demand ischemia" rather than indicative of obstructive coronary artery disease (CAD). Nonetheless, differentiating transient tachycardia-related injury from an acute coronary syndrome (ACS) can be difficult. We report a case of a 71-year-old woman whose SVT episode ultimately served as the first clue to underlying severe CAD. Her progressively rising high-sensitivity troponin (HS-Tn) required further evaluation. The patient subsequently underwent coronary angiography that revealed significant multivessel coronary artery disease. This case highlights that escalating HS-Tn levels following SVT should not be automatically attributed to demand ischemia, particularly in patients with cardiovascular risk factors.
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